Are Dietary Supplements Safe?

It’s a Jungle Out There

Author: Dr. Stephen Chaney

It’s a jungle out there. You probably already know that there are some bad players in the food supplement industry. There are companies that make products that don’t work, products that haven’t been tested for safety and efficacy, products are contaminated, and even products that are dangerous. There are some companies that even make products that contain dangerous drugs – drugs that can kill you.

Are Dietary Supplements Safe?

A recent report (Harel et al, JAMA Internal Medicine, doi: 10.1001/jamaintermed.2013.379) states that between January of 2004 and December of 2012 there were 465 drugs that were subject to a class I recall by the FDA. A class I recall is for cases in which there is a reasonable probability that use of or exposure to a product will cause serious adverse health consequences or death.

Now here’s the scary part: 98% of those recalls were for dietary supplements. The worst offenders were sexual enhancement products (40%), bodybuilding products (31%) and weight loss products (27%). And these weren’t all foreign-made products. 74% were manufactured in the United States.

[Note: If you are good at math, you will have noticed that leaves 0% for recalls of all other dietary supplements].

It’s A Jungle Out There

A perfect example of this scandalous behavior in certain segments of the food supplement industry is the DMAA saga. You may recall that I mentioned this in a recent “Health Tips From the Professor” titled “Are Fat Burning Supplements Safe?” Let me give you a very brief overview of that report, followed by the latest developments.

DMAA is short for dimethylamylamine. It is a stimulant that is chemically very similar to the ephedrine class of chemicals. The less reputable supplement manufacturers often add stimulants to their weight loss and bodybuilding products.

Stimulants do raise metabolic rate so they help with weight loss. They have no effect on athletic performance, but the athletes often feel like they have more energy – so they are popular in bodybuilding products. The problem is that many stimulants are dangerous. They can increase heart rate, cause arrhythmia, and they can kill people.

Because supplements with ephedra, another close realative of ephedrine, killed a bunch of people, the FDA forced supplement manufacturers to remove it from their products a number of years ago. You might have thought that the manufacturers would decide that adding stimulants to their products wasn’t a good idea. But no, they just substituted DMAA for ephedra. And guess what? The inevitable happened again. Two US soldiers died following DMAA usage in 2012.

The DMAA Scandal

The story really gets scandalous from here. The military ordered the removal of all DMAA containing products from U.S. Army and Air Force exchanges, but the FDA did not act. So what happened? Just about what you’d expect. Companies like GNC pulled their DMAA containing products from military bases, but continued to sell them from all their other stores.

Several months later the FDA finally acted. It sent a warning letter to all US manufacturers of DMAA containing products asking them to stop using DMAA as an ingredient in their supplements. All of the companies agreed to stop using it except one – USPLabs.

USPLabs claimed that DMAA could be found in geranium, which is an approved herbal ingredient, so they continued to use it. And GNC continued to sell their DMAA containing products in all its nonmilitary stores.

Finally, on April 11, 2013 the FDA issued a strongly worded warning about DMAA. The FDA warning said that by then there had been 86 reports of illnesses and deaths associated with supplements containing DMAA, and the preponderance of scientific evidence showed that DMAA was not a natural constituent of geranium.

The FDA said that they would take all possible means to get DMAA containing products off the market. A cynic might point out that the FDA did not act until the night before a high profile exposé on DMAA was scheduled to appear on NBC.

Finally, USPLabs threw in the towel and said that they would reformulate their DMAA containing products. A cynic might suspect that they will just substitute yet another stimulant for DMAA.

And, what about GNC? They said “It [DMAA] will be positioned out of stores, probably over the next five or six months as we sell existing inventory”. You don’t need a cynic to interpret that statement.

It wasn’t until the FDA raided their warehouses and removed all remaining DMAA-containing products that the DMAA story was over.

So what’s the bottom line for you? It is a jungle out there. Don’t fall for the hype and fancy claims. Do your homework, and stick with a company you can trust.

The Bottom Line:

1) When you hear headlines about dietary supplements killing people, you should realize that the bad players are found in only 3 types of dietary supplements – sexual enhancement products, bodybuilding products and weight loss products.

2) Just for perspective you should contrast any concerns about the safety of dietary supplements with:

The more than 35,000 deaths/year from properly prescribed medications…and…

The 8,000 deaths/year in US hospitals due to medication errors (Journal of General Internal Medicine, 25: 774-779, 2010)

3) When choosing supplements in that class use your common sense. Avoid those supplements promising magical gains in sexual prowess, increased muscle mass or weight loss.

4) Stick with a supplement company you can trust – one that is committed to only making supplements of proven benefit, and never making supplements that could cause any harm.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

A Sleeping position that has your head tilted puts pressure on your spinal cord and will cause headaches. I’ve seen it happen hundreds of times, and the reasoning is so logical it’s easy to understand.

Your spinal cord runs from your brain, through each of your vertebrae, down your arms and legs. Nerves pass out of the vertebrae and go to every cell in your body, including each of your organs. When you are sleeping it is important to keep your head, neck, and spine in a horizontal plane so you aren’t straining the muscles that insert into your vertebrae.

The graphic above is a close-up of your skull and the cervical (neck) vertebrae. Your nerves are shown in yellow, and your artery is shown in red. Consider what happens if you hold your head to one side for hours. You can notice that the nerves and artery will likely be press upon. Also, since your spinal cord comes down the inside of the vertebrae, it will also be impinged.

In 2004 the Archives of Internal Medicine published an article stating that 1 out of 13 people have morning headaches. It’s interesting to note that the article never mentions the spinal cord being impinged by the vertebrae. That’s a major oversight!

Muscles merge into tendons, and the tendons insert into the bone. As you stayed in the tilted position for hours, the muscles actually shortened to the new length. Then you try to turn over, but the short muscles are holding your cervical vertebrae tightly, and they can’t lengthen.

The weight of your head pulls on the vertebrae, putting even more pressure on your spinal cord and nerves. Plus, the tight muscles are pulling on the bones, causing pain on the bone.

Your Pillow is Involved in Your Sleeping Position and the Causes of Headaches

The analogy I always use is; just as pulling your hair hurts your scalp, the muscle pulling on the tendons hurts the bone where it inserts. In this case it is your neck muscles putting a strain on your cervical bones. For example, if you sleep on your left side and your pillow is too thick, your head will be tilted up toward the ceiling. This position tightens the muscles on the right side of your neck.

Dozing off while sitting in a car waiting for someone to arrive, or while working for hours at your desk can also cause headaches. The pictures above show a strain on the neck when you fall asleep without any support on your neck. Both of these people will wake up with a headache, and with stiffness in their neck.

The best sleeping position to prevent headaches is to have your pillow adjusted so your head, neck, and spine are in a horizontal line. Play with your pillows, putting two thin pillows into one case if necessary. If your pillow is too thick try to open up a corner and pull out some of the stuffing.

Sleeping on Your Back & Stomach

If you sleep on your back and have your head on the mattress, your spine is straight. All you need is a little neck pillow for support, and a pillow under your knees.

Stomach sleeping is the worst sleeping position for not only headaches, but so many other aches and pains. It’s a tough habit to break, but it can be done. This sleeping position deserves its own blog, which I will do in the future.

Treating the Muscles That Cause Headaches

All of the muscles that originate or insert into your cervical vertebrae, and many that insert into your shoulder and upper back, need to be treated. The treatments are all taught in Treat Yourself to Pain Free Living, in the neck and shoulder chapters. Here is one treatment that will help you get relief.

Take either a tennis ball or the Perfect Ball (which really is Perfect because it has a solid center and soft outside) and press into your shoulder as shown. You are treating a muscle called Levator Scapulae which pulls your cervical vertebrae out of alignment when it is tight.

Hold the press for about 30 seconds, release, and then press again.

Your pillow is a key to neck pain and headaches caused by your sleeping position. It’s worth the time and energy to investigate how you sleep and correct your pillow. I believe this blog will help you find the solution and will insure you have restful sleep each night.

Wishing you well,

Julie Donnelly

About The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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The statements in these articles have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease. Any Health Care changes should be made only after consulting with your Doctor and licensed Health Care Advisor.

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